Welcome to the 128th Critical Care Reviews Newsletter, bringing you the best critical care research published in the past week, plus a wide range of free full text review articles, guidelines, commentaries and editorials from hundreds of clinical and scientific journals.

Editorials address REBOA, medical errors, general critical care, and mechanical ventilation. There are numerous commentaries, including papers on sedation, infection control, extracorporeal lung support and clinical informatics. There are also several case reports, including features on brain death and septic ketoacidosis.

Next years meeting will be held on Friday, January 23rd, again at the Galgorm Resort and Spa, just outside Belfast. The theme of the meeting is to discuss recent major research and attempt to answer a single question - should we be implementing the results of this study? The Primary Investigators of some of the largest RCTs in the past 18 months will be there to discuss their studies and the implications for our practice. The first speaker to be announced is Niklas Nielsen, from Sweden, who published the Targeted Temperature Management Study (TTM study) in the New England Journal of Medicine last November. More exciting speakers will be announced over the next few weeks.

Free Open Access Medical Education (FOAM) Websites

There has been a number of developments amongst providers of free online medical education over the past week. Steve Mathieu and colleagues in Portsmouth have released a fantastic new site (The Bottom Line), providing structured appraisals of the major critical care studies. New critiques are being added on a daily basis. On a similar theme, the Critical Care Reviews Top 100 Studies has been updated, with further summaries added. Oli Flower and Matt McPartlin from Sydney have updated their superb site the Intensive Care Network, with a host of new podcasts recently added. Chris Nickson has just released a new site from the Alfred ICU in Melbourne, called Intensive. If you haven't checked out the online critical care community, take a look at some of these websites. There's even a major conference (Social Media and Critical Care, SMACC), which is simply fantastic and will be held in Chicago next year, almost one year to the day, May 20th to 22nd.

In a multicentre, placebo controlled, European exploratory Phase II study, Schinzel and colleagues evaluated the safety and pharmacodynamics of 4-Amino-tetrahydrobiopterin (VAS203), a NO-synthase inhibitor in 32 patients with traumatic brain injury, and found:

Nassar and colleagues compared patients treated in 8 American ICUs (intervention ICUs) before (n=1,708 patients) and after (n=1,647) the implementation of a telemedicine programme, and 3,584 patients treated in concurrent control ICUs that did not implement an telemedicine program, and found:

no differences between intervention and control ICUs during the pre-TM and post-TM periods in

patient demographics

comorbid illnesses

predicted ICU mortality rates were lower for intervention ICUs compared with control ICUs

Patel and colleagues evaluated delirium and sleep before (n=167) and after (n=171) the implementation of a bundle of non-pharmacological interventions, consisting of environmental noise and light reduction designed to reduce nighttime disturbance, and found:

compliance with the interventions was > 90%

the bundle of interventions was associated with (before vs after; mean/SD)

Nielsen and colleagues performed a retrospective propensity-matched cohort study using prospectively collected data from 6,005 consecutive cardiac surgery cases, examining the association between intra- and postoperative use of inotropes and mortality and postoperative complications, and found: